The Effort to Rationalize Antibiotic Use in Indonesian Hospitals: Practice and Its Implication
An effective strategy for combatting AMR in Indonesia is to make the use of antibiotics in hospitals more rational with the help of an Antimicrobial Resistance Control Program (AMR-CP). This study aims to analyze the implementation of the AMR-CP in hospitals by conducting in-depth interviews with he...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Hindawi Limited
2023-01-01
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| Series: | Journal of Tropical Medicine |
| Online Access: | http://dx.doi.org/10.1155/2023/7701712 |
| _version_ | 1797870072835866624 |
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| author | Selma Siahaan Rukmini Rukmini Betty Roosihermiatie Pramita Andarwati Rini S. Handayani Ingan U. Tarigan Tita Rosita Rustika Rustika Yuslely Usman Lusi Kristiana |
| author_facet | Selma Siahaan Rukmini Rukmini Betty Roosihermiatie Pramita Andarwati Rini S. Handayani Ingan U. Tarigan Tita Rosita Rustika Rustika Yuslely Usman Lusi Kristiana |
| author_sort | Selma Siahaan |
| collection | DOAJ |
| description | An effective strategy for combatting AMR in Indonesia is to make the use of antibiotics in hospitals more rational with the help of an Antimicrobial Resistance Control Program (AMR-CP). This study aims to analyze the implementation of the AMR-CP in hospitals by conducting in-depth interviews with health professionals from ten hospitals and health officers of ten provincial health offices in ten different provinces and observation towards its documents. The sample location was selected by purposive sampling. Informants at the hospitals were hospital directors, chairmen of the AMR-CP team, chairmen of the medical committee, persons in charge of the microbiology laboratory, clinicians, nurses, clinical pharmacists, and those program managers at the provincial health offices who are responsible for administering antibiotics. Information is first collected and then a thematic analysis is applied along with triangulation to confirm the validity of information from multiple sources, including document observation results. The analysis is adapted to the framework of the system (i.e., input, process, and output). Results show that hospitals in Indonesia already have the resources to implement AMR-CP, including AMR-CP team and microbiology laboratories. Six hospitals examined also have clinicians trained in microbiology. Though hospital leadership and its commitment to implementing AMR-CP are favorable, there is room for improvement. AMR-CP teams organize routine activities for socialization and training, develop standard operating procedures (SOPs) for antibiotic use, antibiotic patterns surveillance, and bacterial mapping. Some obstacles to implementing AMR-CP policies are posed by the human resources, facilities, budget, antibiotics and reagent shortages, and clinician compliance with SOPs. The study concludes that there was an improvement in antibiotic sensitivity patterns, rational use of antibiotics, use of microbiological laboratories, and cost-efficiency. It recommends the government and healthcare providers continue to improve AMR-CP in hospitals and promote AMR-CP policy by making the regional health office of the hospital a representative of the regional government. |
| first_indexed | 2024-04-10T00:21:34Z |
| format | Article |
| id | doaj.art-e5e098d431674430b5f3eafa5580af11 |
| institution | Directory Open Access Journal |
| issn | 1687-9694 |
| language | English |
| last_indexed | 2024-04-10T00:21:34Z |
| publishDate | 2023-01-01 |
| publisher | Hindawi Limited |
| record_format | Article |
| series | Journal of Tropical Medicine |
| spelling | doaj.art-e5e098d431674430b5f3eafa5580af112023-03-16T00:00:54ZengHindawi LimitedJournal of Tropical Medicine1687-96942023-01-01202310.1155/2023/7701712The Effort to Rationalize Antibiotic Use in Indonesian Hospitals: Practice and Its ImplicationSelma Siahaan0Rukmini Rukmini1Betty Roosihermiatie2Pramita Andarwati3Rini S. Handayani4Ingan U. Tarigan5Tita Rosita6Rustika Rustika7Yuslely Usman8Lusi Kristiana9Organization Research for HealthOrganization Research for HealthOrganization Research for HealthOrganization Research for HealthOrganization Research for HealthOrganization Research for HealthCentre for Health Financing and Decentralization PolicyOrganization Research for HealthCentre for Health Financing and Decentralization PolicyOrganization Research for HealthAn effective strategy for combatting AMR in Indonesia is to make the use of antibiotics in hospitals more rational with the help of an Antimicrobial Resistance Control Program (AMR-CP). This study aims to analyze the implementation of the AMR-CP in hospitals by conducting in-depth interviews with health professionals from ten hospitals and health officers of ten provincial health offices in ten different provinces and observation towards its documents. The sample location was selected by purposive sampling. Informants at the hospitals were hospital directors, chairmen of the AMR-CP team, chairmen of the medical committee, persons in charge of the microbiology laboratory, clinicians, nurses, clinical pharmacists, and those program managers at the provincial health offices who are responsible for administering antibiotics. Information is first collected and then a thematic analysis is applied along with triangulation to confirm the validity of information from multiple sources, including document observation results. The analysis is adapted to the framework of the system (i.e., input, process, and output). Results show that hospitals in Indonesia already have the resources to implement AMR-CP, including AMR-CP team and microbiology laboratories. Six hospitals examined also have clinicians trained in microbiology. Though hospital leadership and its commitment to implementing AMR-CP are favorable, there is room for improvement. AMR-CP teams organize routine activities for socialization and training, develop standard operating procedures (SOPs) for antibiotic use, antibiotic patterns surveillance, and bacterial mapping. Some obstacles to implementing AMR-CP policies are posed by the human resources, facilities, budget, antibiotics and reagent shortages, and clinician compliance with SOPs. The study concludes that there was an improvement in antibiotic sensitivity patterns, rational use of antibiotics, use of microbiological laboratories, and cost-efficiency. It recommends the government and healthcare providers continue to improve AMR-CP in hospitals and promote AMR-CP policy by making the regional health office of the hospital a representative of the regional government.http://dx.doi.org/10.1155/2023/7701712 |
| spellingShingle | Selma Siahaan Rukmini Rukmini Betty Roosihermiatie Pramita Andarwati Rini S. Handayani Ingan U. Tarigan Tita Rosita Rustika Rustika Yuslely Usman Lusi Kristiana The Effort to Rationalize Antibiotic Use in Indonesian Hospitals: Practice and Its Implication Journal of Tropical Medicine |
| title | The Effort to Rationalize Antibiotic Use in Indonesian Hospitals: Practice and Its Implication |
| title_full | The Effort to Rationalize Antibiotic Use in Indonesian Hospitals: Practice and Its Implication |
| title_fullStr | The Effort to Rationalize Antibiotic Use in Indonesian Hospitals: Practice and Its Implication |
| title_full_unstemmed | The Effort to Rationalize Antibiotic Use in Indonesian Hospitals: Practice and Its Implication |
| title_short | The Effort to Rationalize Antibiotic Use in Indonesian Hospitals: Practice and Its Implication |
| title_sort | effort to rationalize antibiotic use in indonesian hospitals practice and its implication |
| url | http://dx.doi.org/10.1155/2023/7701712 |
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